Deal Plan Would Allow Mini Hospitals For Rural Areas

In the wake of some recent closures of rural Georgia hospitals, Gov. Nathan Deal announced Wednesday an initiative to help such facilities survive tough financial times.

Deal, speaking to the Rural Caucus of the General Assembly, said he is proposing a change in licensure rules that would allow a struggling rural hospital — or one that has recently closed — to offer downsized services that would include an emergency department.

Such a facility could also provide childbirth services and some kinds of elective surgery, he said.

Four rural hospitals in Georgia have closed in the past two years, and a total of eight have folded since 2000.

“Communities should not have to go without crucial services — many of them lifesaving — simply because they fall in a rural ZIP code,’’ Deal said.

Besides increasing the medical risk to people, a hospital closure also devastates a rural area’s economy, he noted.

The downsizing licensure change would not require legislation, Deal said.

Deal also said the Department of Community Health would designate an employee “point person’’ for rural hospitals who would receive up-to-date information about their financial problems. And a rural hospital stabilization committee would be created to identify needs and solutions for these facilities.

Deal also mentioned $12 million in funding already approved for air ambulance service for people in southwest Georgia. And he added that the state’s telehealth services provide digitalized doctor consultations on a variety of health problems experienced by rural residents.

Clyde Reese, commissioner of the Department of Community Health, alluded to the licensure changes last week, saying he would ask the board of the agency to promulgate rules for such a “step-down’’ facility.

Reese told GHN on Wednesday that the agency had agreed to advance a struggling Fort Oglethorpe hospital and nursing home a total of more than $800,000 in already scheduled funding. “They needed this to make payroll,’’ Reese said.

Rural lawmakers and health care officials said they were pleased with Deal’s announcements.

Patty Bentley (D-Reynolds) said the licensure change could help a Macon County hospital reopen. Flint River Hospital, in the south-central Georgia town of Montezuma, closed last year. “This is excellent news,” Bentley said.

Matt Caseman of the Georgia Rural Health Association also said the moves will be beneficial, and can help persuade doctors to stay in rural communities. “If the hospital can remain open in some form, it’s less likely the physicians will leave.’’

Jimmy Lewis of HomeTown Health, an organization of rural hospitals, said Deal “has taken a very positive step in addressing the crisis in rural health care.’’

The announced moves won’t end the crisis, Lewis said, but will provide “a different form of medical access.’’

But while a “step-down’’ hospital may be allowed simply through regulatory changes, it could take action by legislators to allow a community that lost a hospital more than a year previously to build a facility such as a standalone emergency room.

Experts say many rural hospitals — which have large numbers of uninsured patients — would be helped financially under an expansion of Medicaid, because many of those people would get coverage. But the governor, backed by the Republican leadership in the Legislature, has said “no” to expansion, citing the costs to the state.

And the state Legislature has passed a bill that would add another step to any move toward Medicaid expansion. The bill would require legislative approval, not just the governor’s OK, for expansion to take place.